| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $582.00 | $629.00 | $2,530.00 | |
Cigna
| Facility | AS | $94.32 | $94.32 | $94.32 |
Kaiser Permanente
| Professional | $828.95 | $1,018.54 | $1,418.93 | |
United
| Facility | $418.00 | $453.00 | $1,330.00 |